Endoscopic surgical procedures are gaining wide acceptance among surgeons and patients. There are many benefits associated with the use of endoscopic surgical procedures including reduced postoperative infection rate, reduced pain, decrease in both the post operative recuperative period and the duration of the hospital stay, and improved cosmesis. The term endoscopic as used herein is defined to include endoscopic, laparoscopic, thoracoscopic and arthroscopic, and, similar minimally invasive surgical techniques.
Numerous endoscopic surgical procedures have been developed including cholecystectomy, appendectomy and tubal ligation. Various types of endoscopic surgical instruments have been developed for use in these endoscopic procedures including endoscopic clip appliers, endoscopic sutures, endoscopes, endoscopic staplers, trocars, and trocar cannulas, and the like.
Although certain types of digestive disorders of the stomach are treatable with various types of pharmaceuticals, or changes in dietary habits, it is known that certain types of conditions are only responsive to surgical intervention. One such condition is intractable gastroesophageal reflux disease which typically involves the distal esophagus. A valvular mechanism exists at the junction of the esophagus and stomach which prevents acid from splashing up and entering the lower esophagus. When the fundus does not function properly, acid is allowed to splash into the esophagus. The symptoms of this condition include heartburn, regurgitation, dysphagia (difficult swallowing), chronic bronchitis in some, and chest pain. The conventional surgical remediation for this condition is known as an anti-reflux procedure. In the conventional anti-reflux procedure, an incision is initially made into the abdominal cavity. Once inside the abdomen, the surgeon completes the anti-reflux procedure by mobilizing the esophagus, then dividing the top short gastric vessels, and finally wrapping the fundus of the stomach around the distal esophagus. The wrap is secured with sutures. The purpose of this technique is to create a flap of stomach tissue about the esophagus that functions as a valve between the stomach and the esophagus, thereby preventing stomach acid from entering the lower esophagus. There is a need in the surgical field for such an anti-reflux operation performed using a minimally invasive endoscopic procedure. There is also a need in this art for endoscopic suturing instrumentation which can be used to perform endoscopic surgical procedures such as an endoscopic anti-reflux procedure.